Cervical screening changes to prevent 600 cancers

The process of cervical screening is to be changed to allow women to benefit from better, more accurate tests, Public Health Minister Jane Ellison announced.

The new testing process could prevent around 600 cancers a year, according to Cancer Research UK.

After a successful pilot programme and a recommendation by the UK National Screening Committee, screening samples will be tested for Human Papilloma Virus (HPV) first. This will be rolled out across England as the primary screening test for cervical disease.

Current testing process

At the moment, screening samples from women are first tested with the cytology test. During this process, a highly trained technician, known as a cytologist, will examine a sample for abnormal cells that could go on to develop into cancer. Although cytologists are extremely well trained and accurate, the cytology test leaves room for abnormal cells to be missed, because sometimes they look similar to normal cells. It also leaves room for normal cells to be misdiagnosed as abnormal. Testing for the Human Papilloma Virus (HPV) is used as a secondary measure in women needing further investigation. Women with mild or borderline cytology results are tested for HPV and if negative are returned to the routine screening programme. Women who are HPV positive are referred to colposcopy, a medical examination of the cervix.

New testing process

In the new process, the sample will be tested for the Human Papilloma Virus (HPV) first. As 99.7% of cervical cancers are caused by HPV, if the virus is found, it will mean that the cytologists have a useful guide to know whether abnormal cells might be present, and the woman can be monitored more closely, so that any developing abnormal cells can be caught sooner. If no HPV is present, then the test can minimise over treatment and anxiety for women.

Public Health Minister, Jane Ellison, said:

These changes are a breakthrough in the way we test women for cervical disease. The new test is more accurate, more personal and will reduce anxiety among women.

Cervical screening currently saves 4,500 lives a year, and this new test will ensure the early signs are spotted and treated earlier.

Sir Harpal Kumar, Cancer Research UK’s chief executive, said:

It’s a huge step forward that the Government is now introducing the HPV test to improve cervical screening. Testing first for the human papilloma virus will help prevent more cervical cancers, as it can pick up the cancer-causing infection before any abnormalities can develop in the cells.

The cervical screening programme saves thousands of lives every year by preventing cancer and research shows that this change will make the programme even more effective. More lives will also be saved by detecting the disease early, when it is more likely to be treated successfully.

The need for improvements to the cervical screening programme was set out in the cancer strategy for England last year, so it’s good to see progress being made.

Robert Music, Chief Executive Jo’s Cervical Cancer Trust:

We are delighted that the Minister has announced the implementation of HPV primary screening. Evidence shows that this new test will see higher detection rates and a more reliable indicator which will help identify women at greater risk of developing cervical cancer.

Ultimately the quicker this is rolled out, the sooner we will see fewer women diagnosed or losing their lives to cervical cancer.

Dr Anne Mackie, Public Health England’s Director of Screening, said:

Evidence suggests that testing for the Human Papilloma Virus (HPV) first has several benefits over the current method of examining cervical samples, called cytology, including picking up more cell abnormalities.

We are currently working with NHS colleagues to confirm details to ensure an effective implementation.

About cervical cancer

The majority (99.7%) of cervical cancers are caused by persistent human papillomavirus (HPV) infection which causes changes to the cervical cells

2,590 women were diagnosed with cervical cancer in England in 2014

726 women died of cervical cancer in England in 2014

Women aged 25-49 are invited for cervical screening every 3 years and from 50-64 every 5 years

About HPV (Human Papillomavirus)
• Anyone who has ever been sexually active is at risk of contracting HPV
• Around 13 high-risk types of HPV are responsible for causing cervical cancers, types 16 and 18 are the most prevalent, causing over 70 per cent of cervical cancers
• Four out of five (80 per cent) women are infected with genital HPV at some point in their lives without ever knowing they have been infected because HPV is usually cleared (without treatment) by the body's immune system, with 80 per cent of cells healing within two years
• A small percentage of women do not clear the infection and it can remain 'dormant' (inactive) or persistent, sometimes for many years. If your immune system doesn't clear the infection and/or the abnormal cells are not removed or monitored, the DNA of the HPV virus can join with the DNA of the epithelial cells, creating cancer cells. This is why cervical screening and HPV vaccination are important in helping to spot abnormalities and prevent cancer
• Research has shown that changes in abnormalities do not usually escalate quickly and it can take between 5 to 20 years for a cancer to develop.